LIFE CARE CENTERS OF AMERICA, INC. (NPI# 1316993793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316993793 |
| Entity Type | Organization |
| Organization Name | LIFE CARE CENTERS OF AMERICA, INC. |
| Other Organization Name | CITADEL CARE CENTER |
| Practice Address |
5121 E Broadway Rd Mesa AZ 85206-1308 |
| Mailing Address |
3001 Keith St Nw Cleveland TN 37312-3713 |
| Practice Telephone | 4808325555 |
| Practice Fax Number | 4809240090 |
| Mailing Telephone | 4234735751 |
| Mailing Fax Number | 4233398342 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2008-02-12 |
| Authorized Official Name | CINDY S CROSS (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 4234735867 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | ALC2407 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 356148 | 05 |
| Other Name | Type Code |
|---|---|
| Citadel Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750448437 | Life Care Centers of America, Inc. | Respite Care | 1625 Carr St, Lakewood, CO 80214-5926 | 2007-01-02 |
| 1083771679 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 1990 W Loucks St, Sheridan, WY 82801-4500 | 2007-01-02 |
| 1467540070 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 4041 S Poplar St, Casper, WY 82601-5928 | 2006-10-10 |
| 1467461103 | Life Care Centers of America, Inc. | Respite Care | 530 W 16th St, Salida, CO 81201-2240 | 2006-08-05 |
| 1164440103 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 1510 Cypress Gardens Boulevard, Winter Haven, FL 33884 | 2006-07-17 |
| 1356367700 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 8104 Tuttle Ave, Sarasota, FL 34243-2885 | 2006-07-15 |
| 1235155680 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 355 Crossing Blvd, Orange Park, FL 32073-2860 | 2006-07-15 |
| 1497771836 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 3720 Se Jennings Rd, Port St Lucie, FL 34952-7701 | 2006-07-15 |
| 1417973389 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 2800 Sw 41st St, Ocala, FL 34474-4454 | 2006-07-14 |
| 1427083799 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 501 W Economy Rd, Morristown, TN 37814-3222 | 2006-07-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith St Nw, Cleveland, TN 37312 |
| Connecticut Business Registrations | LIFE CARE CENTERS OF AMERICA, INC. | 114 South Main St, Bel Air, MD 21014 |
| Washington State Corporations | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith St Nw, Cleveland, TN 37312-4309 |
| Oregon Corporations, Companies and Business Names | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith Street Nw, Cleveland, TN 37311 |
| Massachusetts Corporations | LIFE CARE CENTERS OF AMERICA, INC. | 3570 Keith St.,n.w., Cleveland, TN 37312 |
| Street Address |
5121 E BROADWAY RD |
| City | MESA |
| State | AZ |
| Zip Code | 85206-1308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497269427 | Vidya Sujal Bhat | Physical Therapist | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2017-11-29 |
| 1063880243 | Higley Healthcare, Inc. | Clinic/Center | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2015-09-04 |
| 1568842854 | Higley Healthcare, Inc. | Skilled Nursing Facility | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2015-06-02 |
| 1114256369 | Life Care Centers of America, Inc. | Clinic/Center | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2009-12-17 |
| 1780811679 | Susan Cestaro-smith | Skilled Nursing Facility | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2009-06-17 |
| 1760631485 | Randee Marie Rohn | Occupational Therapist | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2008-09-18 |
| 1427246016 | Amy Elizabeth Thiele | Physical Therapist | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2007-10-09 |
| 1649393141 | Gregory Noga | Physical Therapy Assistant | 5121 E Broadway Rd, Mesa, AZ 85206-1308 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508249038 | Colette Eneboe | Skilled Nursing Facility | 1015 S Val Vista Dr Unit 27, Mesa, AZ 85204-5674 | 2015-07-01 |
| 1801225594 | Daniel Jayson Kronemeyer | Skilled Nursing Facility | 530 W 6th Dr, Mesa, AZ 85210-2316 | 2013-11-04 |
| 1316296122 | Rithirat John Mccollum | Skilled Nursing Facility | 255 West Brown Rd., Mesa, AZ 85201 | 2012-09-07 |
| 1407152812 | Asante of Mesa, LLC | Skilled Nursing Facility | 5358 East Baseline Road, Mesa, AZ 85206-4716 | 2011-02-02 |
| 1508037987 | Pinnacle Health Facilities Xxvi Lp | Skilled Nursing Facility | 6461 E Baywood Ave, Mesa, AZ 85206-1744 | 2008-03-13 |
| 1265543607 | Sunrise Mesa Health Care Center Inc | Skilled Nursing Facility | 3130 E Broadway Rd, Mesa, AZ 85204-1740 | 2006-08-31 |
| 1528179801 | Springdale Village, Inc. | Skilled Nursing Facility | 7255 E Broadway Rd, Mesa, AZ 85208-9201 | 2006-08-31 |
| 1295768620 | Ahc of Mesa LLC | Skilled Nursing Facility | 5755 E Main St, Mesa, AZ 85205-8814 | 2006-07-09 |
| 1528006012 | Mesa United Medical Investors Limited Partnership | Skilled Nursing Facility | 330 S Pinnule Cir, Mesa, AZ 85206-1636 | 2006-06-04 |
| 1114975810 | Evergreen Mesa Christian, L.L.C. | Skilled Nursing Facility | 255 W Brown Rd, Mesa, AZ 85201-3404 | 2006-05-04 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.